Dreaming of opening your own clinic? Or, perhaps you are tired of handing the red tape associated with practicing as a nurse practitioner? Laws regulating NP practice vary significantly between states and can affect what your job looks like on a day to day basis. For example, some states require NPs to work within a certain radius of an overseeing
physician and others regulate nurse practitioner’s prescribing abilities. One state’s laws may permit you to open your own clinic with ease while another’s could have you jumping through hoops. Regardless of your reasons for seeking independence in your practice, living in a nurse practitioner friendly state can certainly give you more room to grow in your NP career. Which states fare best when it
comes to nurse practitioner scope of practice laws? 1. Washington State Residents of Washington State have an overall liberal mindset. You can’t visit Seattle, after all, without seeing a some blue hair and a few wannabe rockers pining away for the 90’s. This independent mindset extends to nurse practitioners practicing in the state. Physician
involvement is not required in practice or prescribing for NPs living in Washington State. Furthermore, Washington was the first state, and remains one of the few in the nation, that currently allows nurse practitioners to prescribe medical marijuana. 2. New Mexico New Mexico’s Governor, Susana Martinez, is a big fan of nurse practitioners so the
state has scope of practice laws to match. NPs practicing in New Mexico may practice and prescribe independently of physician oversight. Not only are New Mexico’s laws regulating nurse practitioners among the most favorable in the nation, the state is actively recruiting NPs to its ranks. Recently, New Mexico implemented an ad campaign in neighboring Texas encouraging nurse practitioners to
relocate to neighboring New Mexico where scope of practice laws are more favorable. As an added bonus, New Mexico also offers NPs practicing in rural areas a $3,000 tax credit. 3. Oregon Oregon has long recognized the value of nurse practitioners to healthcare. For example, the state began allowing NPs to prescribe controlled substances as early as 1979. Nurse practitioners working in Oregon may both practice and prescribe without physician oversight. Aspiring NPs should note that in Oregon, new nurse practitioners are required to have at least 384 hours of registered nursing experience outside of the academic setting in order to obtain a nurse practitioner license, a requirement not held by most other states. 4. Alaska Like Oregon, Alaska has a rich history of supporting nurse practitioners. Alaska began adapting scope of practice laws granting NPs more freedom as early as the 1980’s and hasn’t looked back since. Physician involvement in diagnosing, treating, and prescribing for patients is not required for nurse practitioners practicing in Alaska. Furthermore, new NPs may begin practicing immediately upon graduation, even while certification exam results are pending. This allows for a smooth transition from education to practice. 5. New Hampshire “Live free or die”, New Hampshire’s state motto rings true for nurse practitioners practicing in the state. Like all other states on our list, New Hampshire does not require physician supervision or collaboration in practice or prescribing when it comes to NPs. The state also has a provision for newly graduated nurse practitioners allowing a temporary license to practice before sitting for the national certification exam. This gives new nurse practitioners a seamless transition from education to practice. 6. Arizona Arizona completes our list of most nurse practitioner friendly states. Nurse practitioners working in Arizona enjoy the freedom to practice and prescribe independently. Within this freedom, however, state law specifies that NPs must practice only within their area of certification, they should not “exceed the limits” of their advanced practice specialty. Overall, west is best when it comes to nurse practitioner scope of practice regulations. Five of the top six most favorable states for NP practice lie in the western half of the country. While these states stand out above others when it comes to offering nurse practitioners freedom in their practice, more and more states are jumping on the NP independence bandwagon. Soon, we could see all 50 states mirroring the practice and prescribing laws of the nation’s most nurse practitioner friendly locales. You Might Also Like: Legislative Lash Out- NP Scope of Practice Laws in the News
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Everything you need to know about BMD and the industry. New York, Kansas, Massachusetts, and Delaware Become the latest States to Adopt Full Practice Authority for Nurse PractitionersClient AlertWhile the COVID-19 pandemic certainly created many obstacles and hardships, it also created many opportunities to try doing things differently. This can be seen in the instant rise of remote work opportunities, telehealth visits, and virtual meetings. Many States took the challenges of the pandemic and turned them into an opportunity to adjust the regulations governing licensed professionals, including for advanced practice registered nurses (APRNs).
On April 15, 2022, Kansas became the latest state to remove practice restrictions on nurse practitioners and allow them to practice completely independent of any regulatorily mandated contractual relationship with a physician. This was very shortly after similar changes were made in New York, Massachusetts, and Delaware. In total, 26 States, the District of Columbia, and two U.S. territories (Guam and Northern Mariana Islands) now permit nurse practitioners to practice without any mandated collaborative agreement or supervision. Many other States, including Ohio, are currently evaluating legislation to implement full practice authority for APRNs. A map illustrating the current position of all U.S. States and territories regarding full practice authority can be found here. It should be noted that each full practice authority State is different with regards to the requirements to practice independently. For example, some States require a transition to practice period where the APRN practices under supervision or regulatory collaboration for a minimum period of time before being licensed to practice independently. The trend towards adopting full practice authority for APRNs will have a direct impact on the number of patient care roles that will be filled by APRNs. Over the course of seven years (as reported in 2020), the number of nurse practitioners in the U.S. more than doubled. Additionally, the U.S. Department of Labor expects the number of jobs held by nurse practitioners, CRNAs, and certified nurse midwives to increase 45% between 2020 and 2030. If you have questions about APRN practice rules or starting an APRN-driven business, please don’t hesitate to contact Jeana Singleton by email at: , or by phone at: (330) 253-2001 or another member of the Health Law Department at Brennan, Manna & Diamond. Posted by Jeana M. Singleton Blog Post, Client Alert Community Banks: Collaboration, not isolation, is the key to protecting/ enhancing the cannabis business you pioneeredAugust 26, 2022As we prepare for the plenary session of the informal institutional cannabis lenders community announced in my previous article, I am pleased to advise that participants now include 5 of the best-known dedicated loan funds; a select group of commercial banks ranging in size from single state community banks to mid-size regionals making cannabis loans into the mid-8 figures; and, a syndicator of credit union cannabis loans. Posted by Stephen LennClient AlertInflation Reduction Act: Healthcare ProvisionsAugust 22, 2022On August 16, 2022, President Joe Biden signed into law the Inflation Reduction Act (the “Act”), a landmark climate, healthcare, and tax bill. Though the Act’s climate provisions have received most of the media attention, the healthcare aspects of the Act present some of the most significant changes to the American healthcare system since the passage of the Affordable Care Act. Posted by Daphne Kackloudis and Ashley WatsonClient AlertThe Current State of Assignment of Benefits Litigation in FloridaAugust 5, 2022On May 25, 2022, Florida lawmakers approved property insurance reforms that remove attorney’s fees, with respect to assignment of benefits (“AOB”) property insurance litigation. One-way attorney’s fees are a longstanding problem in Florida and the reforms come at a time when AOB litigation increasingly affects homeowners in a negative way. Posted by Nhan T. Lee with Wayne A. ComstockClient AlertProposed Community Revitalization Grants for Ohio ProjectsJuly 27, 2022Jason A. Butterworth client alert ohio tax credits historic preservation tax credits community revitalization grants Posted by Jason A. Butterworth with Jonathan ZigaClient AlertOhio Senate Bill 225 Paves the Way for Greater Investment in Opportunity Zones and Historic DistrictsJuly 26, 2022Ohio Senate Bill 225 is poised to make dramatic enhancements to certain tax credit programs in Ohio, specifically those surrounding investments in “Opportunity Funds” and historic buildings. Signed into law by Governor Mike DeWine in June 2022, the Bill is positive news for real estate developers working to revitalize Ohio communities with investment and rehabilitation projects. Posted by Jason A. Butterworth with Jonathan ZigaWhich states are the most restrictive for nurse practitioners?The Best & Worst States for Nurse Practitioners: Scope of Practice. Can a NP open their own practice in Texas?Yes. National certification is one of the requirements for licensure as an APRN in Texas. However, you must meet all of the requirements that are outlined in Rules 221.3 and 221.4 in order to be licensed, practice, or hold yourself out as an APRN in Texas.
Is Idaho a full practice state?NPs in Idaho have FPA, so they can advise, diagnose, and treat patients. In this largely rural state, professionals who earn advanced practice registered nurse (APRN) licensure also have the authority to prescribe medications to patients.
Is Florida a restricted state for nurse practitioners?Medical schools cannot graduate enough physicians to meet the need. Florida, however, is restricting Nurse Practitioners (NPs) from being able to help ease this physician shortage.
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